Comment by noelwelsh | Hacker News Reader

Comment by noelwelsh | Hacker News Reader

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I believe the NHS is seriously under-funded, the Tory government is responsible, and healthcare is suffering as a result.

However, I do want to provide an anecdote to illustrate that private healthcare is not perfect. I had some persistent pain in my foot. Realized I wouldn't get anywhere with the NHS so I went private. The person I saw had an excellent manner. They suggested some fairly gnarly surgery. Said I should think about it and in the meantime they gave me an anti-inflammatory injection. My problem cleared up in about two weeks. What was wrong: I have really really wide feet (seriously; they are wider than the widest setting on the foot measuring device they use at shoe shops.) I didn't know this. I was wearing Chuck Taylors, which are very narrow, and they were pinching my feet. I didn't wear my Chucks over the two weeks and I figured out what was wrong in that time. What I learned: everyone has a toolbox they want to reach into. In this case I was seen by a surgeon so they of course turned to surgery as solution. Always be your own advocate, to the best of your ability, in healthcare. (I thought the surgeon might have said something about the width of my feet given they spent so much time looking at feet.)

Long ago I broke my collarbone in a bicycle race. It's a common injury in the sport so I got a referral to a surgeon from another racer who'd had a fracture of his own surgically repaired. To my surprise, she took a very conservative course of action. The clavicle had broken pretty cleanly in half and the outer half had settled in about an inch inward underneath the inner half. You might think that would be a good candidate for surgery so the bone could have been moved back into the old position with the help of a plate. But she thought it would be best if I came back in a few weeks and see if it had healed on its own. To my amazement, it did heal so that now I have a weird knob in my clavicle but the bone feels as strong as the never broken side. The recovery was tough though and took years. At times I wished I'd had it surgically repaired but now I admire my surgeon's restraint. She correctly diagnosed that I didn't need surgery to recover even though she had no personal relationship to me and a financial incentive to operate. But I also saw that since she operated on my friend that she would operate if she deemed it necessary. Thus I believe that she actually evaluated each case carefully on its own. Unfortunately, the tendency towards pushing patients into lucrative active interventions (like surgeries) does seem common even if it isn't the rule.

My Canadian experience with that injury was basically the surgeon would operate on me if I wanted, and that would get me back to 100% faster, but it's more invasive and largely unnecessary unless your everyday life required faster healing (e.g. you job depends on it). Which it didn't because I had a desk job.

There might be an age component to it: the risk of it not healing correctly increases with age.

As a percentage of GDP, the UK has the 6th highest healthcare spending of OECD countries, on par with Switzerland. The UK is not an outlier in terms of spending.

https://stats.oecd.org/Index.aspx?DataSetCode=SHA

Some of that is probably down to the dysfunctional models that have been brought in (in the name of 'cost saving' or 'efficiency' or what ever nonsense) - like Blair's PFI model where they signed up to pay £80 billion to private investors over the long term for what amounted to £13bn of actual investment... This seems to have continued under the Tories and the UK public are on the hook to continue to pay huge repayments to private companies for decades to provide services that could have just been publicly funded in the first place...

Much more detail on funding problems here: https://nhsfunding.info/nhs-crisis-making/

These feet looked like the nicest weekend ever, probably. (To the surgeon.)

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